Leaked letter sparks alarm: Eastern Cape Health Department calls it fake

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JEREMY MAGGS: Now, a leaked letter from the Oliver and Adelaide Tambo Regional Hospital in the Eastern Cape has sparked concern after it claimed that starting this week there would be days with no doctors on call due to an acute shortage. The Eastern Cape Health Department has responded. It’s dismissed the letter as fake, but I think the bigger issue remains, does the hospital and others in the province have enough doctors to provide proper care?

I’m in conversation now with Dr Mthandeki Xamlashe, Deputy Director General for Clinical Services in the Eastern Cape Health Department. Doctor, a very warm welcome to you. So first of all, what evidence do you have that proves this letter is fake or forged? Was it an internal document that the department wants to own or what is the situation?

MTHANDEKI XAMLASHE: Thank you very much, Jeremy, for the opportunity to share the issues around the fake letter. Our definition of fake letters and news, number one, starts with any official who writes a document without delegation or authority to do so.

The second one, we have communication protocols, like in any organisation, within the department in terms of dealing with the general public on any operational issues. For any document to be authentic, it must adhere to those two conditions. This one doesn’t. Therefore, it is fake from our point of understanding, from our own perspective.

JEREMY MAGGS: Right. So those are your protocols. But the letter is signed by the chief executive officer of the hospital, Mr Tshaka. Can you confirm that he did write the letter?

MTHANDEKI XAMLASHE: I spoke to Mr Tshaka, myself personally. I’m his immediate supervisor. He disowned the letter; he disassociated himself from the contents of that letter. So I dealt with him directly and I believed him and I said he must do so in writing and sign, which is something he’s doing right now.

But the bigger issue for me, as you [mentioned] now [in the] beginning in your introduction, was what was affecting the public and the consumers, apart from the letter itself, that is what we’re dealing with now.

JEREMY MAGGS: But Doctor, he wouldn’t have written the letter unless there was a problem at the hospital. Does the problem that he outlined, that I mentioned in my introduction, still stand? In other words, no doctors on call until further notice.

MTHANDEKI XAMLASHE: No, that is certainly not the case, Jeremy. We have doctors at Oliver and Adelaide Tambo Regional Hospital. We have 16 registered doctors; we have two clinical associates. In order to offer services on a 24-hour basis that hospital needs 14 doctors to cover the duty roster.

They have 16 doctors who are on site, who are available to cover 24-hour services, complemented by two clinical associates who work under supervision. So we do have doctors, that is a fact, that’s verifiable at any given time. That is the fact at Oliver and Adelaide Tambo Regional Hospital [Oath].

JEREMY MAGGS: It’s extraordinary then that the chief executive of the hospital saw fit to write this letter.

MTHANDEKI XAMLASHE: I will take his position that he disowns the letter. He disowns its circulation and its content. That’s why I asked him to do so in writing. So I will only be able to give you a final answer on that, when he sends that correspondence and he said it’s fake and he doesn’t own it.

But as I said to you earlier on, my interest was that, is it true that there are no doctors? The doctors were there. I know them by name because I work with them, even at night. I know the doctors were on duty on 20 January. I know the doctors [are] on duty tonight. The bigger issue at Oath is not the content of the letter. The real issue at Oath is the increase in the demand for services.

Since the government introduced the specialists to that facility, the government is in the process of upgrading that facility to become a regional hospital and a lot of interventions have been put in place and support programmes have been introduced.

It’s a district hospital that has got orthopaedic surgeons now. It’s a district hospital that has got obstetricians and paediatricians as part of a programme of upgrading it to a regional hospital. Because of that, a lot of clients from that area started going to that hospital.

So we are dealing with a demand issue and then we are now on top of that employing eight medical officers, on top of the 16 who we have, as part of upgrading that hospital. The other issues that are really getting into the space are just there to contaminate our very good programme that was launched by the honourable premier [Oscar Mabuyane] and the MEC [Ntandokazi Capa] and supported by our HOD [Sindisiwa Gede].

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JEREMY MAGGS: Doctor, notwithstanding what you’ve just said to me, we also hear about young doctors struggling to find placement. Why is this happening, particularly in the Eastern Cape, and what is your department doing about it?

MTHANDEKI XAMLASHE: Jeremy, this time please forgive me, may we allow this to be dealt with by the national health minister [Aaron Motsoaledi]. It’s not an Eastern Cape problem, Jeremy. It’s a national programme…

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JEREMY MAGGS: But it affects, but Doctor, it affects Eastern Cape hospitals, which is solely within your preserve.

MTHANDEKI XAMLASHE: It affects all provinces. Our premier, our MEC are working with the national minister to deal with the matter, and I really would not want to get into that space because they are available definitely to you to deal with that directly. I would not love to really deal with a particular small corner about such a big and national issue, knowing very well that my principals are dealing with it.

JEREMY MAGGS: But the fact that you can’t place young doctors has an impact, surely, on your ability to provide health service.

MTHANDEKI XAMLASHE: We have placed young doctors; the community services will get cohorts every year. The doctors who are saying [they] are not being placed, have been replaced by other comservs [community service]. The same cohort will be replaced the following year. So this is an ongoing revolving [Inaudible ] programme.

We have placed doctors in various hospitals in the Eastern Care. We’ve got the numbers and they’re out there. It’s official. I think now it’s about, not placement, it’s just about employment that the doctors are talking about.

When junior doctors come into the system, they come as interns. They are placed, not employed. After internship they do community service, they’re also placed, they’re not employed. After community service, then they have to apply for jobs both in public and in private. I think those are the colleagues who you’re talking about. That’s what the national minister and the premiers are dealing with right now.

JEREMY MAGGS: I’m going to leave it there. Dr Mthandeki Xamlashe, thank you very much indeed, Deputy Director General for Clinical Services in the Eastern Cape Health Department, I appreciate your time.

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